Kudos to M D Schmidt, S I Sulsky, and P J Amoroso.[1]
The authors described how military hospitals' researchers not only
collected medical records, but then acted to prevent or reduce a trend of
serious hospitalized injury continually treated. They compiled and
organized injury data on parachuting, studied the nature and extent of
injury types and assessed injury prevention and control enginee...
Kudos to M D Schmidt, S I Sulsky, and P J Amoroso.[1]
The authors described how military hospitals' researchers not only
collected medical records, but then acted to prevent or reduce a trend of
serious hospitalized injury continually treated. They compiled and
organized injury data on parachuting, studied the nature and extent of
injury types and assessed injury prevention and control engineering
outside-the-boot ankle braces, for both civilians and military
parachutists.
In 1961, there was a similar seminal investigation conducted by Drs.
William Haddon Jr., director of the epidemiology resident program, New
York State Department of Health, Albany, New York (Haddon was the
father of modem injury prevention and control who stressed evidenced-based
research); Arthur Ellison, an associate in orthopedics at the student
health services of Williams College Williamstown, Mass.; and Robert
Carroll, a student at Albany Medical Center.[2] They studied all
persons purchasing tickets to ski areas on the four consecutive weekends
from Jan. 28 through Feb. 19, 1961 and showed that the primary evidence
for preventing serious skiing was using certain release binders.
The current leadership on prevention of parachute-related injury,
published in the Injury Prevention and the archival initial pioneering
leadership work of Haddon some 40 years earlier, again validates the
efficacy of interventions applying evidenced-based (or promising)
injury reduction systems.
Les Fisher, MPH
Les Fisher M.P.H.
Safety / Management Consultant
(Archivist, American Public Health Association, ICEHS Section (see
injury prevention history leadership commentaries at http://www.icehs.org
Newsletters and Members' Only)
97 Union Avenue South, Delmar NY, 12054 ,USA; 518-439-0326.
The opinions are mine alone.
References
1. M D Schmidt, S I Sulsky, and P J Amoroso. Effectiveness of
an outside-the-boot ankle brace in reducing parachuting related ankle
injuries.Inj Prev 2005;11 163-168.
Anyone who is in doubt about the need for protective headgear should
request a computer print-out of hospital admitted (or treated) cases from
the U.S. Consumer Products Safety division. With less than 10% of soccer
head injuries being reported, the long, detailed list of injuries would
shock even those who are against soccer headgear. These figures leave
very little room for any one to deny the need...
Anyone who is in doubt about the need for protective headgear should
request a computer print-out of hospital admitted (or treated) cases from
the U.S. Consumer Products Safety division. With less than 10% of soccer
head injuries being reported, the long, detailed list of injuries would
shock even those who are against soccer headgear. These figures leave
very little room for any one to deny the need for soccer headgear.
It is true soccer headgear needs to be improved to the point it covers not
only full head protection but should also give some protection for heading
of a soccer ball. Heading is still the unknown to some, but with the
death of a professional English soccer player (Jeff Astell), the coroner's
report states that his death was from long-term heading of a soccer ball. A
soccer ball fully inflated weighs 16oz and can travel at a speed of 0 to
70+ mph. In soccer there are only two ways to advance a
ball: kicking and with the head. It is up to the rule makers of
soccer (FIFA) and the parents of young players to make the decision to
protect the players - it is not a decision to be made by young players or
those who have not researched the issue of soccer head
injuries.
Kangaroo soccer headgear does provide full head protection
and is now introducing a helmet with an impact disbursement plate in the
header pad for forehead protection in heading, and continue to improve
the helmet as new materials and research presents themselves.
Why is IIHS such a staunch critic of driver education programs? To
suggest driver education is a way to "crash proof" novice drivers is just
silly. Driver education provides students with tangible skills that set
the foundation for the acquisition of mature driving skills and judgement.
Driver education at its best is a team effort involving schools,
communities, students, and families.
Why is IIHS such a staunch critic of driver education programs? To
suggest driver education is a way to "crash proof" novice drivers is just
silly. Driver education provides students with tangible skills that set
the foundation for the acquisition of mature driving skills and judgement.
Driver education at its best is a team effort involving schools,
communities, students, and families.
While IIHS focus is on engineering safer cars, there is still a need
to address safer road user behaviours through enhanced enforcement,
education, reinforcement, and graduated licensing legislation.
Cars don't crash, PEOPLE crash cars.
We teach civics--many people don't vote. We teach nutrition--many people
don't eat balanced diets. We teach about vehicle crashworthiness--many
people buy cars with poor crash ratings. We teach the essential knowledge
and skills needed to manage driving risks--many drivers still take
unnecessary risks.
How do you temper the heady mix of youth, mechanical power, and newly
-discovered freedom? How do you counteract the effects of young drivers'
role models who are drunk, enraged, unbelted drivers? We don't know do
we?
Have you looked at the data (Texas, Colorado, etc.) to see the
difference between the crash rates of parent-taught and formal driver
education programs?
Following is the 2003 and 2004 fatality data for VA teens.
Age -- 2003 -- 2004
15 ----- 9 ----- 5
16 ---- 19 ---- 21
17 ---- 31 ---- 30
18 ---- 22 ---- 29
19 ---- 26 ---- 38
Total - 107 --- 123
It's interesting to note that the data shows older teens' crash
rates are significantly higher than younger teens' rates. DO they drive
more? Maybe. Gain a few years of experience and take more risks?
Maybe. Have less parent involvement? Maybe. All of the above? Maybe!
Think about it. Where can you experience the sensation of power,
"rock out" in a chair that adjusts to fit every curve on your body, talk
on the phone, eat, drink, and act irresponsibly (and sometime violently)
in public and still have the illusion of anonymity? Have you hugged your
car today? Now throw in youthful risk taking, thrill-seeking behaviour
with little to no adult supervision and yes we have a tragedy in the
making.
While parents and peers have a significant impact on risk-taking
behaviours, effective teachers influence student achievement and behaviour
in a powerful way. Driving is far from the simple task it is perceived to
be and driver education is an important component in the process of
preparing novice drivers to effectively handle this dangerous task.
I would like to invite you to visit our classrooms/driver education
vehicles to shadow some our students so you can observe firsthand their
skill acquisition. You will have the opportunity to see the difference
between an educated and a clueless driver.
You may also be interested in looking at our transfer student,
public, non public, and commercial school driver education program
graduates' first-year crash data located at
http//www.doe.virginia.gov/VDOE/Instruction/PE. We use this data to
evaluate and improve our instructional programs.
We need to be on the same team to help students understand the
fundamentals of driving and to foster responsible attitudes and driving
behaviours needed for safe motor vehicle operation.
Please don't encourage throwing the baby out with the bath water. I
have no desire to share the road with under educated drivers!
Why do some research professionals continue to hold positions that
result in avoiding a serious overhaul of, and investment into, educating
new drivers? Education-testing young drivers warrants as much attention
and investment as crash-testing new vehicles! Exploring how to teach and
motivate teen drivers will result in knowledge that is likely more
valuable to society and traffic safety than expl...
Why do some research professionals continue to hold positions that
result in avoiding a serious overhaul of, and investment into, educating
new drivers? Education-testing young drivers warrants as much attention
and investment as crash-testing new vehicles! Exploring how to teach and
motivate teen drivers will result in knowledge that is likely more
valuable to society and traffic safety than exploring the crush of a new
vehicle!
Researchers Allan Williams and Susan Ferguson of the Insurance
Institute for Highway Safety (IIHS) have weighed in once again on their
position regarding driver education. Although they title their article
“Driver’s Education Renaissance?”, their comments reflect an old position
that does not promote education; it promotes delaying and avoiding
education. The premise of this position is kids who don’t drive won’t
crash, and educating someone on how to do something will result in them
doing it. Their commentary is posted at the Injury Prevention Online Web
site [2]. This article is a rebuttal to the position they put forward.
This author found no positive suggestions for improving driver
education in the Williams and Ferguson commentary, yet research abounds on
how people learn, [3] and the body of knowledge on how it applies to driver
education, although still largely ignored, continues to grow [4]. Their
specific, useful positive suggestions are limited to the agreed benefits
of various elements of graduated driver experience models. But, because
driver education results in kids driving, they also recommend that access
to driver education be made less convenient by removing it from high
schools.
Those who would define the agenda on teen driver education should be
able to offer something more positive than to make driver education less
convenient to the general public. This suggestion leads this author to
believe they are at a loss on how to improve driver education, or as to
what role it can provide in improving the learning experiences of young
drivers.
Their commentary continues their public message that scarce public
dollars will be wasted if spent on driver education. They disclose that a
good driver education program results in more skilled drivers, but the
context and underlying message is “skilled drivers are not necessarily
safe drivers.” [5]. Even so, the article also conveys the fact that efforts
over the past couple decades to convince the public that education
measures are useless has failed, and with that admission the article
appears to divulge a concern that efforts to keep public dollars from
being invested into driver education are at risk.
The Williams and Ferguson article appears to be part of a strategy,
perhaps well intended, to counter the ongoing struggle to adequately fund
and improve driver education—a counter stimulated by renewed interest of
the public and Congress in driver education. The struggle that exists
between some researchers and those who directly work with teens is a
challenging conundrum. Most parents and teachers believe education is
important to help teens learn safe driving behaviours, but some of those
who review literature and research at arms length from young, aspiring
drivers believe teens should not be taught to do something that might
result in their harm.
Would Williams or Ferguson consider delaying young minds from being
taught the basics of the scientific method? Any teacher can tell you that
young minds will err in their methods, analysis and conclusions until they
learn, through experience, to master the skill. Yet, society knows that
young minds should be taught. Teachers, therefore, work patiently, over
time, to establish a foundation of knowledge in the scientific method and
provide expanding experience, helping students overcome errors and produce
more accurate conclusions in more complex scientific inquiries. Society
demands this be done because society understands the value of the
educational process.
The facts cited by Williams and Ferguson overlook new emerging
reports coming out of Washington and Oregon that indicate teens whose
learning experience includes a standards-based, state-approved driver
education program are safer drivers than those who do not take a state-
approved driver education program [6]. In addition, what is known by
research is not the only useful body of knowledge relating to teen
drivers. The writers report “86 percent” of the public “considered
driver education courses ‘very important’ in training new drivers to drive
safely.” Those who are closer to the real world have ways of understanding
things that frustrate the analytical and necessarily myopic world of
research and empiricism. We must respect what is unscientifically
"known" by the public. In fact, intuitive knowledge and hunches are an
important seedbed of hypotheses that eventually become scientific
knowledge.
Champions and guardians of empirical knowledge are invaluable
contributors to public discussion and policy development. However, I
learned years ago that while the advice of accountants and researches is
very important, unless those analyzing the data understand the heartbeat
of the business, their advice may not result in the hoped for outcome.
Why is that? It is because the world of science is a discovery process
and what has been empirically explored and documented represents only the
tiniest piece of the universe of knowledge awaiting exploration. Despite
our great and wonderful advances, what is unknown is far greater than what
is known, and what is thought to be known is often, at best, only
partially known.
It is not unusual for researchers to warn that a particular effort
represents a focus for which there is no scientifically proven value, only
to find through additional research that there is evidence of its value.
Examples of this abound [7].
Delaying license may reduce crashes for the younger teens, but what
does it do for the older teens who have yet to learn to drive, and how
does that help rural states that insist on young teens being able to
drive. At some point the would-be driver must learn to drive and begin
the path of acquiring experience. Society has invested too little effort
and resources into improving methods of initial instruction. The public
intuitively knows that education has to play a part as certainly as the
staff at the IIHS know that young minds must be taught the scientific
method.
Perhaps the driver education agenda should be defined by experts in
education, learning development and human behaviour who have explored the
nuances of the human mind and know the heartbeat of the education and
training process. Perhaps its time to expand the dialogue to folks who
have suggestions other than Williams’ and Ferguson’s suggestion to avoid
or delay the task, and who are willing to forge ahead and improve a driver
education system that has yet to embrace present education and training
knowledge and technologies. Perhaps experts at crashing cars and
calculating the costs of crashes for insurance companies are not the
experts that can best advance solutions to the driver education
challenges.
The bottom line is that experience without skilled and knowledgeable
instruction will lead to reinforcement and establishment of poor and
illegal driving behaviours and habits. Society can’t expect the teen
driver to drive safely if they do not know how. A quality driver
education and training experience is the foundation for safe driving
behaviour. That foundation needs to be true and sound so that subsequent
safe-driver initiatives can build upon that foundation of knowledge and
skill, including public policies that encourage improved driving norms for
all drivers [8].
In the words of Russell W. Davenport [9], “Progress in every age
results only from the fact that there are some men and women who refuse to
believe that what they know to be right cannot be done.”
For more on the suggestions of this author (David Huff) and other
experts who believe something positive can be done, visit the Driver
Education Forum sponsored by the National Transportation Safety Board at
http://www.ntsb.gov/Events/symp_driver_ed/symp_driver_ed.htm.
David C. Huff 1
References
1. David C. Huff is the director of traffic education for the state
of Montana through the Montana Office of Public Instruction. He has a
master of science in education--learning development with an emphasis on
traffic education.
3. One such resource: National Research Council. (2000). How people
learn: Brain, mind, experience, and school. Washington, D.C.: National
Academy Press.
4. The National Institute for Driver Behavior is one organization
that applies brain-based research on how teens learn to driver education
curriculum and technologies. http://www.NIDB.org.
6. National Highway Traffic Safety Administration research report on
Oregon at 2005 Lifesavers Conference, and research reports on Washington
driver education programs delivered at 2003 and 2004 American Driver and
Traffic Safety Education annual conference by Nickolas Lovrich and Steve
Ellwanger, Washington State University.
7. In the 1960s some members of the medical community warned there
was no evidence of vitamins C and E’s value as a preventative treatment
for various ailments. Today, however, they are valued as an important
part of a healthy diet, as anti-oxidants that fight free radicals and
among other things, recognized as potentially beneficial in preventing
cancer (http://www.cancer.gov/newscenter/pressreleases/antioxidants). A
similar campaign by some scientists resisted alternate theories on the
causes of ulcers. We now know that some forms of ulcers are caused by
bacteria, are easily cured, and not just the symptoms of too much stomach
acid (http://www.cdc.gov/ulcer/).
8. This author recognizes that even the best driver education efforts
will have less positive long-term benefit than desired if the driving
norms of society are poorer than the desired behaviours taught to the new
driver. The teens will soon drive like the parents and neighbors who
perpetuate the norms. Solutions must also be pursued for improving the
norms of all drivers. See the author’s recommendations at the National
Transportation Safety Board Web site listed in the closing paragraph
above, and comments by: Evans, L (2004) Traffic Safety, Chapters 13 and
16. http://scienceservingsociety.com
In a short article, Rosengart et al. (“An evaluation of state firearm
regulations and homicide and suicide death rates”) attempt to evaluate the
effect of 5 different state regulations on four different outcomes
(firearm suicide, suicide and firearm homicide, homicide). There is much
that is good about this article, but a problem, perhaps due to space
constraints, is that the authors do not discuss s...
In a short article, Rosengart et al. (“An evaluation of state firearm
regulations and homicide and suicide death rates”) attempt to evaluate the
effect of 5 different state regulations on four different outcomes
(firearm suicide, suicide and firearm homicide, homicide). There is much
that is good about this article, but a problem, perhaps due to space
constraints, is that the authors do not discuss some important limitations
or caveats for many of their analyses. These limitations substantially
reduce the likelihood that the authors will detect any effect of four of
the laws (minimum age for purchase; for possession; one-gun-per-month;
junk gun ban).
For example, they evaluate the effect of laws raising to (or lowering
from) 21 the minimum legal age for (a) handgun purchase and (b) handgun
possession. Changing the minimum legal age from 18 to 21 or 21 to 18
mainly affects 18-20 year olds. Ideally, the evaluation should focus on
the effects on this age group, with comparisons to other age groups. But
the only age comparisons provided are for ages 0-19, and 20 and over.
This evaluation doubly dilutes the possibility of finding any effect--by
including many age groups with the 18-20 year olds, and then by cutting
the 18-20 group in two. The authors are in effect seeking to find a
measurable impact of the law on the overall rate of (say) firearm
suicides. They are very unlikely to find such an effect, even if it
exists. In 2002, for example, 18-20 year old firearm suicides accounted
for only 3.7% of all firearm suicides. If the law could have had an immediate and incredible effect of reducing 18-20 year old firearm suicides by 25%, the effect on overall firearm suicides would have been
less than 1%, not readily detectable by the evaluation. [For homicides, since the effect of the law should primarily be observed on perpetrators age 18-20, an evaluation with the power to detect an effect would probably need to use 18-20 year old perpetration data rather than victimization
data].
The authors also try to evaluate the effect of one-gun-per month
laws. The authors’ essentially are comparing what happened pre and post in
a state like Virginia which passed a one-gun-per-month law, to what
happened in other states like New York, which did not pass such a law. A
problem with their approach is that one purpose of these laws is to reduce
gun running across state lines, from states with permissive gun laws (e.g.
Virginia) to those with more restrictive laws (e.g. New York). A one-gun-
per-month law in Virginia may help reduce gun availability and homicide in
New York. But in the authors’ calculations, these lives saved would be
counted against the law’s effectiveness.
I believe the authors try to do too much. They focus on the
evaluation of concealed carry laws, but then add, with little modification
or discussion, evaluations of four additional laws. But each of these
laws deserves its own careful and nuanced evaluation. I do not have a
strong priors concerning whether any of these four laws had any effect,
but I don’t believe the paper by Rosengart et al. provides a proper
evaluation. Given their methodology, I am not at all surprised that the
authors find little evidence “that any of the (four) laws evaluated were
associated with a significant reduction in either firearm homicide or
firearm suicide rates.”
An open letter to the Insurance Institute for Highway Safety (IIHS).
Please, don’t train and evaluate my surgeon, airline pilot or
electrician as well as we prepare our nation’s youthful drivers.
Studies showing little or no “crash reduction” benefit from
traditional driver education programs have concluded that they have little
or no benefit, or the disbenefit of getting these students on the road
sooner. But aren’t the programs themselves ineffective at achieving crash
reduction? Can we expect a demonstration of improvement in the short time
and attention allotted to those programs? Didn’t the DeKalb study show
that a students who took a “little better” program fare a little better
for a little while? What results could we expect through a “lot better”
program.
We have no evidence that it wouldn’t work.
Why would the insurance industry condemn the motivation to improve?
As evidence, didn’t “every driver that ever crashed”, pass their DMV
driver’s test? We haven’t seen any scrutiny on the ineffectiveness of DMV
standardized testing based on the gruesome evidence of GES data.
From the tragic statistics, the recent tsunami, the 911 terrorism and
the serial mid-eastern wars pale in comparison to the perpetuated human
tragedy of car crashes. Small mistakes make for big consequences with a
moving automobile even if, through engineering, the car is made to be more
crash protective. The forensics show that the victims suffer from some
mistake, their own or someone else’s. We’re all accountable.
Six million crashes and 40,000+ U.S. fatalities per year? After ten
years or forty years? The totals are staggering.
What is to be done? How can we reduce the error rate? However,
unintentional or inadvertent, most crashes aren’t accidents.
Failure is when your best isn’t good enough.
Please don’t believe that violence of this proportion is inevitable
or has to be the price of our free, independent mobility.
I contributed on an advisory committee for the National Highway
Traffic Safety Administration (NHTSA) several years ago. The committee
made recommendations on graduated licensing for the states’ legislatures
to ponder. Most states adopted graduated licensing plans that shelved the
more expensive provisions of training and evaluation, in favor of the less
expensive restrictions and required parental involvement. Oh yes, and
enforcement.
The restrictions and supervision are, gratefully, pointed out as
immediate successes and work primarily because of reduced total youthful
driving exposure, under more controlled conditions and circumstances.
Any parent could have instituted these restrictions at any time prior
to the legislation. Those parents would have had to enforce it themselves
(an unpleasant task in some families).
The international figures show that eight industrialized countries
fare better than the U.S. on their crash and fatality rates. Each of
these countries have more rigorous training (albeit more expensive) for
initial licensing and periodic updates.
Other studies show that few American drivers feel the need to improve
their own driving (“self certified”, “I’m OK”) fewer still have crash
avoidance competency. Forensic crash investigations show that in more than
one third of all crashes, there is no evidence that driver made an attempt
at avoidance. If you hit what is in your way, you probably failed to miss
it. Fatal inability.
All educators know that the most difficult personal factors to
improve are; decision making, judgment and maturity. Twelve years of
English classes most frequently produces readers. How much training
effort does a violinist or quarterback put in? Even the IIHS “Northport”
study stated that emergency procedures training “showed promise” for crash
rate reduction, “when coupled with motivational influences”.
The first time you took a ride in a car (?), and the last time you
will? We’re in cars practically from “womb to tomb”, a lifetime of
potentially hazardous, kinetic mobility.
I hope that your efforts would be to never give up on helping the
individual behave with deliberate effort to be their own best driver . . .
. and endorse whatever (public policy) improvements to driver training and
education that can reduce the accumulation of cost, pain and the fatal
price we’re all subject to.
Despite James Lawson’s best efforts to suggest otherwise [1],
ordinary people – and thankfully nearly all politicians on all sides of
Australian politics -- understand that 10 mass shootings involving 66
deaths in 10 years, followed by 103 months with no such incidents is a
positive development. Opinion polls before and after the 1996 Port Arthur
massacre repeatedly showed overwhelming proportions of A...
Despite James Lawson’s best efforts to suggest otherwise [1],
ordinary people – and thankfully nearly all politicians on all sides of
Australian politics -- understand that 10 mass shootings involving 66
deaths in 10 years, followed by 103 months with no such incidents is a
positive development. Opinion polls before and after the 1996 Port Arthur
massacre repeatedly showed overwhelming proportions of Australians
surveyed believed there was no place in a civilized society for virtually
unrestricted civilian ownership of semi-automatic and pump action weapons
capable of rapidly killing many people [2]. These were the guns that were
banned in Australia in 1996 after the massacre.
People like James Lawson mourn the loss of the ability to own such
weapons and trivialize mass killings (“only 3% of all Australian
homicides”) and gun deaths (“only 12% of Australian suicides and only 16%
of Australian murders.”). The nub of their argument is that people intent
on killing or suiciding will find other means to do so and therefore
policies designed to reduce the ease with which people can kill many
others quickly are ill-conceived.
The reductio ad absurdum of the right to own rapid-fire weapons is
presumably that civilians such as The Coalition of Law Abiding Sporting
Shooters, in the name of freedom to play “sport” with such weapons,
should be allowed to own flame throwers, rocket launchers, grenades,
dynamite, and tanks. People who might one day be dangerous or develop
terrorist proclivities should be identified, they’d argue, so that law
abiding people could play with their rocket launchers, machine guns etc at
will. With the world desperate to pre-identify terrorists, the profound
naivety of this should be obvious to all. If this is not their position
and that they believe the prohibitions on these things are sensible, we
would all appreciate learning where they draw the line.
By the same logic, Dr Lawson would presumably oppose effective
suicide prevention measures that have been associated with reduction in
overall suicide rates such as the strict control of barbiturates[3], the
detoxification of domestic gas supply[4,5], and the construction of access
barriers on high buildings.
Do I believe gun deaths are more important than murders and suicides
not involving guns, and whether it would not be more sensible to try and
reduce all such deaths? The sub-text of the question here is “instead of
going after guns, why don’t you go after larger fish?” This is a bit like
saying “if you can’t fix all health problems, how dare you try to fix any”
or suggesting that diabetes prevention specialists should abandon their
efforts because cancer kills more people.
Public health measures to reduce death and injury always consider the
practicalities and cost-benefits of proposed strategies. The Childers back
-packer murderer Lawson refers to, set fire to a hostel. It would be sheer
folly to ban matches and petrol. Parents who kill their families use a
variety of means such as suffocation, knives and car exhausts, where
similar cost-benefit problems exist in proposals to ban the means.
Plainly, none of these means can be controlled via legislation whereas gun
access can be significantly reduced with the only cost being the loss of
the “freedom” to not be able own one of these ultra-lethal weapons that
the Australian community has repeatedly urged should be banned [2].
Finally, I thank Dr Lawson for his generous comments on my book. He
may be disconcerted to know that I donate royalties to causes such as gun
control.
2. Chapman S. Over our dead bodies. Port Arthur and Australia’s fight for
gun control. Pluto Press 1998. Table 3.1.
3. Schapira K, Linsley KR, Linsley A, Kelly TP, Kay DW. Relationship of
suicide rates to social factors and availability of lethal methods:
comparison of suicide in Newcastle upon Tyne 1961-1965 and 1985-1994. Br J
Psychiatry. 2001 May;178:458-64.
4. Lester D. The effect of restricting access to lethal methods for
suicide: a study of suicide by domestic gas in Japan. Acta Psychiatr
Scand. 1989;80:180-2.
5. Lester D. The effect of the detoxification of domestic gas in
Switzerland on the suicide rate. Acta Psychiatr Scand. 1990;82:383-4.
We read the article by Hendrie et al with interest.[1] Compared to the salaries of their North American and European counterparts, the average Japanese family income is higher. The majority of parents
tend to believe that the cost of child restraint seats (CRS) is comparatively higher than other countries. CRS in Japan are much more expensive - around US$ 250-400. Government subsidiary would
be nece...
We read the article by Hendrie et al with interest.[1] Compared to the salaries of their North American and European counterparts, the average Japanese family income is higher. The majority of parents
tend to believe that the cost of child restraint seats (CRS) is comparatively higher than other countries. CRS in Japan are much more expensive - around US$ 250-400. Government subsidiary would
be necessary to reduce this price and motivate parents to use this highly
effective safety device. This would be expensive, but when
viewed against the huge public health and traffic safety benefits in the long-term, this would be cost effective.[2] As many surveys have found, CRS use in Japan is lower; this strategy would help improve CRS use. Arguably, a moral obligation exists to offer
subsidies that give all children a fair chance of surviving to
adulthood.[1] In 1982-84 the Swedish government introduced a routine
childhood car-seat lending scheme. Sixty-seven % of children used
car seats on short trips and 73% on long trips, which subsequently led to
a decrease in childhood injuries.[3]
References
1. Hendrie D, Miller T R, Orlando M, Spicer RS, Taft C,
Consunji R, Zaloshnja E. Child and family safety device affordability
by country income level: an 18 country comparison. Injury Prevention
10:338-343;2004.
2. Desapriya E B R, Iwase N, Brussoni M, Papsdorf M. Child
motor vehicle occupant casualties before and after enactment of Child
Restraint Seats (CRS) legislation in Japan. Injury Prevention and Safety
Control (In press).
3. Svanstrom L, Schelp L, Ekman R. Sweden, 10 years after,
still a safe community? International J Consumer Safety 1996;3(1):1-7;1996.
I note with interest Chapman's contribution to the discussion[1] on the paper by Ozanne-Smith et al. on firearm law reform in
Australia.[2] Chapman's claims are not incorrect, as far as they go.
However, like Ozanne-Smith et al, it is what Chapman has left out that
may confuse readers.
There have been several mass murders (defined as four or more deaths in
one incident) in A...
I note with interest Chapman's contribution to the discussion[1] on the paper by Ozanne-Smith et al. on firearm law reform in
Australia.[2] Chapman's claims are not incorrect, as far as they go.
However, like Ozanne-Smith et al, it is what Chapman has left out that
may confuse readers.
There have been several mass murders (defined as four or more deaths in
one incident) in Australia since 1996, although none with guns. The worst
was the arson attack in Childers, where 15 people were murdered. Others
have involved knives and parents gassing themselves and their children in
their cars.
The effectiveness of the 1996 Australian gun confiscations ("buy-
back" is a Government euphemism) in reducing suicide and violent crime has
been examined in detail by Reuter and Mouzos.[3]
They find, inter alia, that:
1. Mass murders account for only 3% of all Australian homicides.[4] Of the 13 such killings 1989-90 to 1996-7, only six involved guns.[5] (Chapman's comments are simply irrelevant to over 98% of Australian
murders).
2. "Observed declines in ... homicide continued a long term trend
rather than the effects of the Port Arthur incident."[6]
3. On mass murder, as raised specifically by Chapman, they state "there
has been a modest reduction in severity and frequency ... none have
involved firearms, although the frequency of these events is so low that
not much can be inferred".[7]
4. The lowest Australian gun homicide rate was in 1950,[8] (when there
were no virtually long gun controls at all).
5. "Suicide rates did not fall ... homicides continued a modest
decline."[9]
6. There was a marked rise in total armed and unarmed robbery,
particularly with knives.[10]
7. UK gun bans did not reduce violent crime.[11]
8. "All this is generally consistent with substitution."[12]
The most enthusiastic endorsement Reuter and Mouzos can scrape
together is "There may have been a modest effect on homicides. The number
declined continuing a pre-existing trend ... one could not reject the
hypothesis that it had reduced homicides by 10%."[13] (As the homicide
rate before the 1996 confiscations fluctuated by up to 15% each year,[14] this is not significant). While Reuter and Mouzos do not say so, their
findings suggest that the 1996 confiscations have wasted over half a
billion dollars of Australian taxpayers' money.
Chapman attributes the passage of the 1996 Australian
confiscation laws NOT to hard facts, or any plausible theory, but to years
of prior media advocacy extending over several years BEFORE the Port
Arthur killings.[15] He further urges that such tragedies be "anticipated
and planned for" by such activists to "exploit to advantage" the interest
generated.[16]
Chapman is well known for his enthusiastic use of media advocacy to
bring about changes in the law and teaches tertiary courses on this
subject.[17]
Details of technique are provided in his outstanding text,[18] which
is essential reading for political activists of all persuasions. Despite
the reference to public health in the title, the book is about media
manipulation, with minimal reference to public health principles. There is
nothing on relative risk, cost-benefit analysis, correlation versus
causation or outcome evaluation. There is no matching insistence on
checking actual outcome of the law changes. In particular, Chapman insists
the activist must " frame the debate".[19] In our current context, this
means insisting that we are concerned only with gun murders, not total
murders.
He also recommends the use of "creative epidemiology" in advocacy work, ie reworking the data into "interesting and arresting forms."[20] He actually
does this in his electronic letter where he compares 103 months with 9
years. Chapman describes how to facilitate misrepresentation of extremist
opposing views as being typical of moderate mainstream opposing views.[21]
Many will doubt whether such a simplistic "sound bite"[22] approach
is likely to improve public safety. Browning, in particular, claims that
political activists dress their agendas in public health clothes so as to
claim respectability, moral superiority and sometimes government
funds.[23] In addition, the mass media may well be part of the problem.
Criminologists have repeatedly pointed out the media practice of
concentrating on rare sensational events, thus misleading the public about
crime risks in the real world.[24-26]
It would be very helpful if Chapman and Ozanne-Smith could EITHER
publicly clarify why they believe gun deaths are of much greater
importance than non-gun suicides and murders OR confirm that the real
issue is how to reduce TOTAL deaths, not just deaths from a particular
instrument. We must decide whether the aim is to reduce deaths ONLY from
GUN murders and suicides or deaths from total murders and suicides. Given
limited resources, what is the best way to use them?
Conclusions: 1) The 1996 mass gun confiscations were not nearly as effective as Chapman
implies, if they were effective at all; 2) all political activists should study Chapman's book on media advocacy; and 3) the subtle distinction between "media advocacy" and propaganda, if any,
is unclear and readers may wish to ponder for this for themselves.
I have previously detailed the failure of mass gun confiscation in
both Australia and the United Kingdom to bring about any significant
change in total homicide rates.[27]
References
1. Chapman S. No mass shootings in Australia since gun law reform [electronic response to Ozanne-Smith J, Ashby K, Newstead S, Stathakis V Z, Clapperton A. Firearm related deaths: the impact of regulatory reform] injuryprevention.com 2004 URL direct link to eLetter .
2. Ozanne-Smith J et al. Firearms related deaths: the impact of
regulatory reform. Injury prevention 2004;10:280-286.
3. Reuter P, Mouzos J. "Australia: a Massive Buyback of Low-Risk
Guns".Chapter 4. In: "Evaluating Gun Policy- Effects on crime and
violence". Eds. Ludwig J, Cook P J. Brookings Institute Press, 2003.
4. ibid. p127
5. ibid. p127
6. ibid. p134
7. ibid. p122
8. ibid. p126
9. ibid. p121
10. ibid. p138
11. ibid. p122
12. ibid. p140
13. ibid. p140
14. Mukherjee S, Carcach C. "Violent Deaths & firearms in Australia:
data and Trends". Australian Institute of Criminology 1996. Derived from
Table 3.1, p18.
15. Chapman S. "Over Our Dead Bodies-Port Arthur and Australia's fight for
gun control". Pluto Press 1998. Preface vii, pp 5,8,9. NOTE: This book
may be out of print. Contact Pluto Press Australia (not Pluto UK)
pluto@plutoaustralia.com
16. Chapman S. Over our dead Bodies. ibid. pp 6,7.
18. Chapman S, Lupton D. "The Fight for Public Health-Principles and
practice of media advocacy". BMJ Publishing Group 1994.
19. Chapman & Lupton. Ibid. p12
20. ibid. p160-163
21. ibid pp158-9.
22. Chapman S. Over Our Dead Bodies op. cit. p90.
23. Browning RW. "Exploiting Health-Activists and Government v the
people". Canonbury Press 1992. Pp 3,4,13.
24. Mouzos J., Segrave M. "Homicide in Australia. 2002-2003 National
Homicide monitoring program Annual Report". Australian institute of
criminology 2004. p3.
25. Weatherburn D. "Law and Order in Australia-Rhetoric and reality". The
Federation Press 2004. pp 2,3,48
26. Grabowsy P., Wilson P. "Journalism and Justice-How crime is reported".
Pluto Press Sydney. 1989. Especially chapters 2,8,9.
27. Lawson J B. Re: Firearm related deaths: the impact of regulatory reform. [electronic response to Ozanne-Smith J, Ashby K, Newstead S, Stathakis V Z, Clapperton A. Firearm related deaths: the impact of regulatory reform] injuryprevention.com 2004 URL direct link to eLetter
I read the response from Chapman with interest.[1] In referring to the number of guns handed in during the 1996/97 buy back, Chapman fails to disclose that those firearms, legally owned by
farmers and sporting shooters, had never been a problem in society. I
refer to the submission by Australian Institute of Criminology to the
publication "Evaluating Gun Policy: Effects on Crime and Violence"
published...
I read the response from Chapman with interest.[1] In referring to the number of guns handed in during the 1996/97 buy back, Chapman fails to disclose that those firearms, legally owned by
farmers and sporting shooters, had never been a problem in society. I
refer to the submission by Australian Institute of Criminology to the
publication "Evaluating Gun Policy: Effects on Crime and Violence"
published by Brookings Institute Wash. USA, in which the topic of
Australia's gun laws was covered under the heading of "A massive Buy Back
of Low Risk Guns"!! Murder by firearm has always been a relatively rare
occurence in Australia.
Since the harsh gun laws of 1996/97, contrary to Chapman's claims, there
have been several mass murders; the Childers (QLD) Fire Massacre, in which
15 young backpackers were murdered, and the Snow Town (S.A.) "bodies in
the barrels" case, in which 12 people were murdered (by piano wire!) as
well as several cases where parents murdered their children (and sometimes
themselves) by knife, bathwater, pillows and car exhaust. (ref. A.I.C.
Research Report no 46).
The tragic mass murders, where a firearm was selected as the weapon,
should have been treated as problems of mental health, not of firearms
ownership! As long as mental health is ignored in our community, murders
and suicides will continue to be a problem. Those in the medical
profession, who choose to place the blame for such occurrences, on legally
owned firearms, are simply diverting attention from the real issues.
On the topic of mobile telephones, I do not need to offer any supporting
data, as reference was made to mobile telephone ownership, as an example
of the many variables that should have been taken into account, in
analysing what had happened since 1978. I might well have highlighted the
increasing use of CCTV surveillance of shopping centres and railway
stations, or of the dramatic increase in private security guards, armed
with handguns, who now patrol our streets. All of the above, and many
other factors, may have had an effect on "gun deaths" , but the original
paper by Monash Uni Accident Prevention Unit, failed to take any of those
factors into account.
Further study should also be made of the useage of firearms for self-
defence. It can be assumed that if just one person at Port Arthur in 1996,
had been carrying a firearm, the number of deaths might have been as low
as 2 or 3, rather than 35.
References
1. Chapman S. No mass shootings in Australia since gun law reform [electronic response to Ozanne-Smith J, Ashby K, Newstead S, Stathakis V Z, Clapperton A. Firearm related deaths: the impact of regulatory reform] injuryprevention.com 2004 URL direct link to eLetter
Dear Editor,
Kudos to M D Schmidt, S I Sulsky, and P J Amoroso.[1]
The authors described how military hospitals' researchers not only collected medical records, but then acted to prevent or reduce a trend of serious hospitalized injury continually treated. They compiled and organized injury data on parachuting, studied the nature and extent of injury types and assessed injury prevention and control enginee...
Dear Editor,
Anyone who is in doubt about the need for protective headgear should request a computer print-out of hospital admitted (or treated) cases from the U.S. Consumer Products Safety division. With less than 10% of soccer head injuries being reported, the long, detailed list of injuries would shock even those who are against soccer headgear. These figures leave very little room for any one to deny the need...
Dear Editor,
Why is IIHS such a staunch critic of driver education programs? To suggest driver education is a way to "crash proof" novice drivers is just silly. Driver education provides students with tangible skills that set the foundation for the acquisition of mature driving skills and judgement. Driver education at its best is a team effort involving schools, communities, students, and families.
W...
Dear Editor,
Why do some research professionals continue to hold positions that result in avoiding a serious overhaul of, and investment into, educating new drivers? Education-testing young drivers warrants as much attention and investment as crash-testing new vehicles! Exploring how to teach and motivate teen drivers will result in knowledge that is likely more valuable to society and traffic safety than expl...
Dear Editor,
In a short article, Rosengart et al. (“An evaluation of state firearm regulations and homicide and suicide death rates”) attempt to evaluate the effect of 5 different state regulations on four different outcomes (firearm suicide, suicide and firearm homicide, homicide). There is much that is good about this article, but a problem, perhaps due to space constraints, is that the authors do not discuss s...
Dear Editor,
survivethedrive.org “Your Best Behind the Wheel”
An open letter to the Insurance Institute for Highway Safety (IIHS).
Please, don’t train and evaluate my surgeon, airline pilot or electrician as well as we prepare our nation’s youthful drivers.
Studies showing little or no “crash reduction” b...
Dear Editor
Despite James Lawson’s best efforts to suggest otherwise [1], ordinary people – and thankfully nearly all politicians on all sides of Australian politics -- understand that 10 mass shootings involving 66 deaths in 10 years, followed by 103 months with no such incidents is a positive development. Opinion polls before and after the 1996 Port Arthur massacre repeatedly showed overwhelming proportions of A...
Dear Editor
We read the article by Hendrie et al with interest.[1] Compared to the salaries of their North American and European counterparts, the average Japanese family income is higher. The majority of parents tend to believe that the cost of child restraint seats (CRS) is comparatively higher than other countries. CRS in Japan are much more expensive - around US$ 250-400. Government subsidiary would be nece...
Dear Editor
I note with interest Chapman's contribution to the discussion[1] on the paper by Ozanne-Smith et al. on firearm law reform in Australia.[2] Chapman's claims are not incorrect, as far as they go. However, like Ozanne-Smith et al, it is what Chapman has left out that may confuse readers.
There have been several mass murders (defined as four or more deaths in one incident) in A...
Dear Editor
I read the response from Chapman with interest.[1] In referring to the number of guns handed in during the 1996/97 buy back, Chapman fails to disclose that those firearms, legally owned by farmers and sporting shooters, had never been a problem in society. I refer to the submission by Australian Institute of Criminology to the publication "Evaluating Gun Policy: Effects on Crime and Violence" published...
Pages